Opioid Agonist Therapy Program

Opioid Agonist Therapy Program

The Opioid Agonist Therapy Program (formerly known as the Methadone Program) is a provincially-funded program administered by the College of Physicians and Surgeons of Saskatchewan.

Methadone

Methadone is a long-acting, synthetic opioid that has been used in the treatment of opioid use disorder for over fifty years. It is a potent opioid agonist that has good oral bioavailability, a slow onset of action, and a long half-life. It binds strongly to the mu receptor, rendering the receptor inaccessible to most other opioids. Methadone also binds to other receptors. It prevents withdrawal, decreases craving, and blocks euphoria produced by short-acting opioids.

Buprenorphine/Naloxone

Buprenorphine is a long-acting, synthetic opioid used for the treatment of opioid use disorder. Buprenorphine is a partial opioid agonist that can produce sufficient opioid effects to allow opioid-dependent patients to discontinue use without experiencing symptoms of withdrawal. Buprenorphine also has a higher binding affinity and as a result can displace other opioids from the receptors. At moderate doses, the agonist effects of buprenorphine plateau and display a ceiling effect, which makes it safer in overdose situations compared to the effects of full agonist opioids, including methadone (it also results in lower risk of over-sedation). Buprenorphine on its own is very unlikely to cause an overdose, however combining it with sedatives such as alcohol or benzodiazepines can cause respiratory depression and death.

Prescribing Methadone and/or Buprenorphine/Naloxone

Physician requirements that must be met to be granted approval by the Registrar to prescribe methadone and/or buprenorphine/naloxone are outlined in the OATP Policies. When a physician wishes to seek approval to prescribe, he/she must send the signed policy to the OATP along with a request to be approved that would include proof of the required education, and mentorship (if appropriate).